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Vitamin B12 levels in familial Mediterranean fever patients treated with colchicine.

Clinical and experimental rheumatology (2013-10-23)
Ali Ihsan Gemici, Ömür Gökmen Sevindik, Servet Akar, Mehmet Tunca
ABSTRACT

Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease characterised by paroxysmal attacks of serosal inflammation. Colchicine is highly effective in preventing these attacks but it may also disrupt the intestinal absorption of vitamin B12. We hypothesised that patients treated with colchicine for a prolonged period could develop deficiency of the vitamin. Ninety-five adult FMF patients on regular colchicine treatment for at least 2 years and age and sex-matched 90 healthy controls were enrolled and complete blood count with platelets, vitamin B12 and folic acid were measured in each person. We also investigated 15 adult FMF patients who were not yet on colchicine. The mean vitamin B12 values were not significantly different between the groups (352.12 (SD=171.62) pg/mL vs. 360.96 (SD=146.53) pg/mL, p=0.71), but there were significantly more vitamin B12 deficient cases among FMF patients (12 vs. 3; p=0.021) and 3 out of these 12 had megaloblastic anaemia. None of the vitamin B12 deficient controls had anaemia. We could not identify any disorder which might have causative effect for the deficiency among this subgroup. The mean vitamin B12 value of 15 colchicine-naïve cases was not significantly different from patients on colchicine (p=0.356). We did not observe significant vitamin B12 deficiency among colchicine-treated FMF patients but some cases may be more prone to developing this potentially serious disorder.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Vitamin B12, ≥98%
Sigma-Aldrich
Vitamin B12, BioReagent, suitable for cell culture, suitable for insect cell culture, suitable for plant cell culture, ≥98%
Supelco
Cyanocobalamin (B12), analytical standard
Sigma-Aldrich
Cyanocobalamin, meets USP testing specifications
Sigma-Aldrich
Colchicine, BioReagent, suitable for plant cell culture, ≥95% (HPLC)
Sigma-Aldrich
Colchicine, ≥95% (HPLC), powder
Sigma-Aldrich
Cyanocobalamin, tested according to Ph. Eur.
Sigma-Aldrich
Cyanocobalamin, SAJ special grade, ≥95.0%
Supelco
Cyanocobalamin (Vitamin B12) solution, 1.0 mg/mL in methanol, ampule of 1 mL, certified reference material, Cerilliant®
Supelco
Cyanocobalamin, pharmaceutical secondary standard, certified reference material